Cos012 Dual Barber Shop and Cosmetology Salon License Application pub



Yüklə 126,41 Kb.
Pdf görüntüsü
səhifə1/7
tarix26.08.2018
ölçüsü126,41 Kb.
#64777
  1   2   3   4   5   6   7


TEXAS DEPARTMENT OF LICENSING AND REGULATION 

PO Box 12157 Austin, Texas 78711-2157  

(800) 803-9202 



 (512) 463-6599 



 FAX (512) 475-2871 

www.tdlr.texas.gov 



 cs.cosmetologists@tdlr.texas.gov 



 cs.barbers@tdlr.texas.gov 

DUAL BARBER SHOP/COSMETOLOGY SALON LICENSE APPLICATION INSTRUCTIONS 

 

The application must be completed and signed by the applicant.  An application is not considered complete and will not 

be processed until all required items have been submitted.  All information provided must be typed or printed in black 

ink.  Attachments must be submitted on separate pieces of single-sided, 8½” x 11” paper.  Use a paperclip to fasten all 

pages together, with a cashier’s check or money order on top.  Do not use staples.  

 

DOCUMENTS SUBMITTED WITH YOUR APPLICATION WILL NOT BE RETURNED. KEEP A COPY OF YOUR  



COMPLETED APPLICATION, ALL ATTACHMENTS, AND YOUR CASHIER’S CHECK OR MONEY ORDER. 

 

1.  DUAL SHOP/SALON NAME - Write the name of your dual shop/salon as it should appear on your shop license. 



(maximum of 40 characters) 

2.  PREVIOUS BARBER SHOP AND SALON LICENSE NUMBER - If applicable, write the license number of the barber 

shop and cosmetology salon that will become a dual barber shop and cosmetology salon.  

3.  DUAL SHOP/SALON’S MAILING ADDRESS - Write your current business mailing address. This is the address 

where we will send you mail. This address can be a post office box. You can add the zip plus-4 to help the postal 

service deliver mail more efficiently and accurately. Always keep your mailing address current with TDLR. A license 

renewal notice will be mailed to your address of record before the date your license will expire. 

4.  PHONE NUMBER - Write a telephone number, including the area code, where we can reach you or leave a mes-

sage for you during the day. 

5.  EMAIL ADDRESS - Write your email address. Please provide your email address so the department may email li-

cense information and required notices to you. Your email address is confidential pursuant to the Texas Public Infor-

mation Act, and the department will not share it with the public.  

6.  DUAL SHOP/SALON’S PHYSICAL ADDRESS - Write the physical address for your dual shop/salon. A post office 

box cannot be used for this address. Once your license has been issued, you can only change the salon’s physical 

address by applying for a new license. 

7.  FAX NUMBER - Write a fax number, including the area code, where we can send you faxes. 

8.  PHONE NUMBER - Write a telephone number, including the area code, where we can reach you or leave a mes-

sage for your during the day. 

9.  TYPE OF OWNERSHIP - Check the box that indicates how your business is organized. You can find a description of 

the various types of business structures at www.sos.state.tx.us/corp/businessstructure.shtml 

10.  OWNER INFORMATION -  Write the owner information of your business. If this business is a SOLE PROPRIETOR-

SHIP, write your name, social security number, and date of birth in the provided space. Also include your mailing 

address and other requested information.  

 

Social security number disclosure is required by Section 231.302(1) of the Texas Family Code in order to obtain a 



 

license. Your social security number is subject to disclosure to an agency authorized to assist in the collection of 

 

child support payments. For more information regarding child support payments, contact the Texas Attorney General 



 

at: www.oag.state.tx.us/child/index or call (512) 460-6000 or (800) 252-8014. 

 

See item 8 for information on email disclosure. 



11.  ADDITIONAL OWNERS INFORMATION - Write the additional owners’ information of all persons or entities that 

owns at least 25 percent of this business. See item 10 for information on social security number disclosure and item 

7 for information on email disclosure. 

12.  STATEMENT OF APPLICANT - Carefully read the statement before you date and sign your application. 

State law prohibits renewing a license more than once after a licensee has defaulted on a student loan guaranteed by 

the Texas Guaranteed Student Loan Corporation (TGSLC) unless the licensee has entered into a repayment agreement 

with TGSLC. YOU SHOULD CONTACT TGSLC BEFORE FILING THIS APPLICATION if you have defaulted on a stu-

dent loan. An application or renewal may be rejected if this agency has received information from TGSLC that the appli-

cant has defaulted on a student loan. The Texas Guaranteed Student Loan Corporation can be contacted at: Texas 

Guaranteed ATTN: Collections, PO Box 83100, Round Rock, TX 78683-3100, Telephone: (800) 222-6297, 

http://

www.tgslc.org

 or email: cust.assist@tgslc.org. 



 

THIS APPLICATION IS FOR A FULL SERVICE BARBER SHOP AND COSMETOLOGY SALON ONLY.   

SPECIALTY SHOPS ARE NOT ELIGIBLE FOR A DUAL LICENSE.

 

 

 

 

 

YOU MUST MEET ALL REQUIREMENTS WITHIN 12 MONTHS OF THE FILING DATE, OR THE APPLICATION WILL BE TERMINATED. 

 

 

 

 

 

 

APPLICATION FEE: $130 (FEE IS NON-REFUNDABLE) 

 

 

 

 

 

PAYMENTS MUST BE IN THE FORM OF A CASHIER’S CHECK OR MONEY ORDER PAYABLE TO TDLR 

 

 

 

ALL INFORMATION MUST BE TYPED OR PRINTED IN BLACK INK 

1. Dual Shop/Salon Name:

 

 



 

 

 



 

 

 



_______________________________________________________________________________________________ 

 

3. Dual Shop/Salon’s Mailing Address: 

(USED TO RECEIVE MAIL FROM TDLR) (A PO box is allowed for this address.)

 

 



 

 

 



 

 

 



 

 

 



 

 

 



Number, Street Name, Suite Number/Apartment Number 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



________________________________________________________________________________________________________________________________________________________________      

 City                                                                                                                                                              State                                                                                                   Zip Code                  

 

6. Dual Shop/Salon’s Physical Address: 

(A PO box is not allowed for this address.)

 

 

 



 

 

 



 

 

 



 

 

 



 

 

Number, Street Name, Suite Number 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

________________________________________________________________________________________________________________________________________________________________      



 City                                                                                                                                                              State                                                                                                   Zip Code                  

  Sole Proprietorship 

* Corporation 

* Limited Liability Company 

  General Partnership 

* Limited Liability Partnership 

* Limited Partnership 

 

 



 

 

 



9. Type of Ownership:  

7. Fax Number: 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(_______________) ____________________________________________________     

        Area Code         Phone Number 

 

DUAL BARBER SHOP/COSMETOLOGY SALON LICENSE APPLICATION 



PO Box 12157 



 Austin, Texas  78711-2157  



(800) 803-9202 



 (512) 463-6599 



 FAX (512) 475-2871 

www.tdlr.texas.gov 



 cs.cosmetologists@tdlr.texas.gov 



 cs.barbers@tdlr.texas.gov

 

 

 

 

 

 

 

 

 

 

 

 

2. Previous Barber Shop Permit Number: ___________ Previous Cosmetology Salon License Number__________

 

                                   (if applicable)                                                                                                                        (if applicable) 



4. Phone Number: 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(_______________) ____________________________________________________     

        Area Code         Phone Number 

5. Email Address: 

 

 

 

 

 



 

 

 



 

 

 



 

 

 



 

 _______________________________________________________________________________________ 

               

(Ex: johndoe@aol.com) See instruction sheet for disclosure information

 

8. Phone Number: 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(_______________) ____________________________________________________     

        Area Code         Phone Number 

TDLR Form COS012 rev February 2017 

Page 1 of 2 

* Must provide a Federal Tax ID number in item 10. 

 



Yüklə 126,41 Kb.

Dostları ilə paylaş:
  1   2   3   4   5   6   7




Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©genderi.org 2024
rəhbərliyinə müraciət

    Ana səhifə